Mark Borigini M.D.

Overcoming Pain

Worshipping Ancestors, Resenting Parents

Chinese Americans turning American.

Posted Feb 07, 2016

A Chinese New Year is upon us.  People born in the Year of the Monkey are characterized as lively, quick-witted, curious, innovative and mischievous; but it is also believed to be one of the most unlucky years in the Chinese calendar.

The results of a recent study appear to indicate that if you are Chinese American, and poor, and old, it doesn’t really make a difference what animal decorates your place mat when you eat your lunch special.  It is not the year that is unlucky; it is you, and the offspring who take care of you.

Further, the results of this recent study remind us that if you are a Chinese American family caregiver, it may be the case that, well, with longevity, every year feels like an unlucky year.

As reported on the NBC news website, according to the lead researcher of the “Filial Piety Report,” Dong Xinqi, MD, MPH, who directs the Chinese Health, Aging and Policy Program at Rush University Medical Center, “Traditional Chinese values center around the family, and they have major effects in the organization and arrangements for the care of Chinese elderly people. As an important part of Chinese culture, filial piety determines the obligation for adult children to take care of their parents.”

“Obligation” is one of those serious words; an obligation just doesn’t seem fun.  Actually, it may be deadly.

In fact, one in two Chinese-American adults experience symptoms of depression and anxiety as a result of caring for elderly parents, according to the results of this new report on filial piety.

The report, released at the end of last year by health and aging experts from Rush University Medical Center and Northwestern University Feinberg School of Medicine, examines the caregiving burdens and psychological well-being of Chinese adults within the United States — a subject with only "rudimentary understanding" due to scarce data.

"Filial piety is a Confucius virtue that prescribes adult children are obligated to provide adequate care for their parents, both emotionally and instrumentally," said Dong, the study's lead author.  

While family-oriented values remain important within U.S. Chinese families, researchers say, Chinese adults may experience significant health problems as a result of caregiving stress — about 40 percent of the study's participants rated their health as fair or poor.

In the study, it was found that “approximately 70 percent of caregivers are older than the age of 40, so many of them have chronic diseases…and have to deal with the struggles of their own health and wellbeing," Dong said.

Even more disturbing, the research revealed that apparent caregiver mistreatment may be a major source of the physical and emotional wounds that plague Chinese-American caregivers. More than half of adult children screened positive for potential caregiver mistreatment, with one third of participants claiming physical mistreatment by their parents prior to turning 18 years old. Age does not necessarily mellow abusers.

Prior research has shown that the Chinese-American elderly population has increased four times more rapidly than the general U.S. older adult population, and Dong estimates that over the next 20 years 25 percent of older adults in the U.S. will be a Chinese person. With the aging population in mind, understanding and addressing the burdens of adult children caregivers becomes of increasing importance.

Of concern is whether this data impacts the ethnic Chinese suicide rate in the U.S., an ethnic group that experiences a rate that is among the highest in other parts of the world.

Dong and his colleagues appreciate the need to support this unique group of caregivers.

Interestingly, 73 percent of the adult children in the survey admitted that they feel stress from these eldercare duties, and also depression and anxiety, but 60 percent admitted that they could be perpetrators of elder abuse.

The researchers opine that Chinese American adult children, perhaps due to the influence of Western culture, do not fully understand the “Chinese meaning” of filial piety. At the same time, their aging parents tend to have high expectation of “filial piety.”

So, will Chinese Americans fully integrate into American society, and let Social Security and Medicaid and the Dollar Store feed and clothe and care for their parents, as do so many other Americans?  Can they survive traditions that maybe cannot be transplanted to the western world?

We shall await the follow-up that will surely follow.

Happy New Year.